Honduras: Installation Begins

Monday, February 18th
Ray Schmidt

The 7-member GE team arrived yesterday and this morning we headed to the hospital to begin the installation. Over 100 pieces of medical equipment had been taken to the 5th floor where the neonatal unit is located. The unit was so packed with equipment it was difficult to move around for a while until we unpacked the equipment and cleared out all the packing debris.

We actually have a 9-member team if you count Oscar, our driver, guard and translator. Oscar is very eager to help wherever and however he can. He not only drives me around or translates, but at the hospital today he worked until he was exhausted. He unpacked crates, cleaned up all the packing materials, ran errands, and anything else he could find to do.

He kept saying, “You help my people and I want to help too.”

Honduras: Medical Equipment Carcasses

Sunday, February 17

Ray Schmidt

I was down in the basement of the Escuela Hospital (pictured) when I came across a hallway filled with broken medical equipment. The halls were lined with infant warmers, incubators, anesthesia machines and other medical equipment. I know some of the equipment had just reached the end of its life and was being used for spare parts. But some of the equipment had been donated by well-intented organizations and individuals without being checked out before shipment.

In my ten years with Assist International I have seen many such hallways of equipment carcasses. Sometimes the equipment does not work in the first place; sometimes none of the accessories needed to use the equipment were provided; sometimes manuals were not provided and no one knew how to use the equipment. There are many reasons but the result is the same: disappointed hospitals that thought they would be getting equipment that would really help their patients but now just have a hallway filled with useless pieces of metal and plastic.

Assist International will only donate new or fully refurbished medical equipment and then we install it and warranty it for a full year—though we usually continue support long after that period. One of the great things about partnering with GE on medical projects is that the equipment that is donated is new. The equipment is then installed by GE technicians and training is provided by expert GE clinicians. Finally, all that equipment is guaranteed so if the hospital has any problems with it, we will fix it.

Honduras: Close Call

By Ray Schmidt

The next morning (Feb. 16th), I arrived again at the customs office at 8:30 with our clearing agent. We were clearing the most critical piece of electrical equipment that day. There were two electrical panels that were air freighted from the U.S. on Tuesday and arrived on Thursday, Feb. 14. Most of the clearing process was completed yesterday. All we needed was a signature on a document, pay a handling charge, and then pick up the items. We were first in line and the customs officer said that he would sign our document as soon as it was found. The office filed it yesterday but this morning no one could find it. Ninety minutes later it was found. Now we just needed the officer to sign it, but no one could find him.

A little later we found him but he was in the middle of something and would sign our document as soon as he was done. “Give me ten minutes” is something we heard a dozen times today. It’s getting closer to noon—that’s when the customs office closes for the day. We can see this officer through the window and he is working diligently on some other paperwork. Every time he stands up, a dozen clearing agents jump to the window shaking the papers they need signed. Each time he sits down and starts on another set of documents.

11:45AM: Agents become very restless and begin yelling.

11:50AM: Half of the agents still in line give up and leave.

11:55 AM: The officer stands up and comes to the window. We push through the others and stick our piece of paper in front of him to sign. He glances at it and signs. We run to the payment counter, pay the small handling charge, and then sprint to the loading dock. Noon, straight up. We’re good now. Fifteen minutes later our stuff is loaded on a small truck and we are headed to the hospital where the electricians can install the panels today and tomorrow, and we’ll be ready to go on Monday.

It was a close call.

Honduran Customs

February 15

Ray Schmidt


The medical team will start the installation of equipment on Monday, Feb. 18. But before we can begin, all the equipment has to get to the hospital. The most important is the final electrical items that need to be installed over the weekend so that the medical team will have power on Monday. And that means that I get to experience Honduran Customs up close, such as import/export, duties and Customs Office.

Today I spent all day at the Customs office (pictured) in Tegucigalpa with the clearing agent from the Ministry of Health (MOH). One of the agreements with the MOH is that all the donated items will be exempted from customs charges. That means the MOH has to get clearance from the Ministry of Finance, and then the Customs office signs off on it and then we can get the equipment delivered to the hospitals. While most of the equipment had gone through this process there were a few late arriving pieces that still needed go through this. I went along to encourage our clearing agent and to pay any handling charges, minor fees, and truck rental. This would save us the hassle of having to go back to the MOH to cover these expenses and speed up the process.

We arrived at 8:30 AM and left at 5 PM. We were able to get three of the remaining six shipments cleared and delivered. This is the second time that I’ve gone through this process in Honduras, and I still haven’t quite got it figured out. There are at least six different stations you have to go to. Sometimes you just need a signature, or have to pay a small fee, or fill out some paperwork. It all has to be done sequentially. And if one of the officials from whom you need a signature decides to take an early lunch, you’re stuck. Now picture about 100 other clearing agents trying to go through this same process. It can get very frenzied.

But we managed to get six UPS batteries, each the size of a freezer and weighing 2,500 lbs., delivered to the Escuela Hospital so that the electricians could install them.

Hondurus: Landing in Teacup

By Ray Schmidt

I’m excited to go back to Honduras—even though it is Valentine’s Day. We are partnering with GE on another project that will have a great impact in that country. We are donating and installing medical equipment for a 65-bed neonatal care unit. This includes a 10-bed neonatal intensive care unit (NICU), a 25-bed intermediate care unit, and a 30-bed neonatal ward. In addition, the electrical system for the entire unit was upgraded and we added a power supply (UPS) system that cannot be interupted. The UPS will keep the power surges, brown outs and black outs from damaging the equipment.

The Escuela Hospital had over 15,000 births last year. The average stay after a mother gives birth is 8 hours. The hospital just doesn’t have the room to keep mothers and their babies any longer than that unless there are complications.

I arrived this afternoon in Tegucigalpa (Tegus for short) and the landing was quite exciting. Approaching the airport requires a lot of turns and adjustments by the pilot and then a quick drop and landing followed by a slamming on the brakes. It was quite intense. One of the passengers commented that it’s like “landing in a teacup.” I went to Youtube and watched several clips of airplanes landing at the Tegus airport. I now see why the landing was so exciting.

Pecs, Hungary: Installing the Equipment

By Ray Schmidt

Dr. Adamovich is an extremely grateful man. Today he shook my hand and thanked me in his broken English on four different occasions. He thanked the other team members as well. As the director of the neonatal ICU he can't believe all the equipment that was donated for his unit. He was particularly overwhelmed when he saw the new incubator. During the incubator training class for the nurses he couldn't help but jump in and press the buttons and explain all the features of the machine. It was nice to sit back and watch this man, who has dedicated so much time and effort into helping infants, receive a Christmas-like gift. Even though it is for the hospital and all the infants that will benefit from it, the incubator is also a blessing for him.

At one point during the incubator training given by Dr. David Kasting, he pointed out a feature that he called the "baby Susan" because it was like a "lazy Susan" that you see in kitchen cabinets. It allows nurses to rotate the baby inside the incubator so they can access the baby more easily. The ten or so nurses let out an audible, "Ahhhhh," followed by a few small claps.

Later he demonstrated how the incubator can be lowered or raised depending on the size of the nurse. There was this nurse who was just a little over four feet tall that was so delighted with this feature. She could now reach the baby without having to reach above her head.

As we were leaving after a day of training and installation, Dr. Adomovich came into our work room and asked if he could take the baby bassinets. The new bassinets were donated by GE and they are beautiful. We had finished assembling them but hadn't cleaned them yet. He didn't want to wait until tomorrow, so he rolled them out of the room. When I left they were being cleaned and readied for infants. I am anxious to see what they look like in the infant rooms.

I always like these days when the equipment is set up and the training is going on and there is excitement on the faces of the nurses and doctors. Tomorrow, when patients are hooked up to the monitors or placed in the warmers, it will be even better.

I should note here that yesterday we located a very good ice cream parlor in Pecs. I'm sure our bus driver thinks we're a bit odd when after dinner we asked him to drive us downtown to the ice cream place. The temperature was just above freezing, it was kind of late, but the ice cream beckoned and we followed. I think we won him over when we invited him to join us. Good ice cream is always a great way to end a day.

God Bless,

Ray

Pecs, Hungary

Ray Schmidt - November 4th,


Pecs (Hungary) is a beautiful city. The team and I arrived yesterday after a three hour bus ride from the Budapest airport. The city dates back 2,000 years and the wall that surrounded the old city is still intact in many areas. A cathedral with four large towers dominates the town center and when lit up at night has an other-worldly glow to it.



Our host for this project is the Pecs Rotary Club and they have treated us well. They took us on a tour this morning of the city including a recently opened UNESCO World Heritage site. The city is built upon layer after layer of ruins dating back millennia and we were able to look at some of the old elaborate tombs. The Rotary club president and his English-speaking daughter then hosted us for dinner and we had a very enjoyable 4-hour meal. No such thing as quick bite to eat, but it was a great time.


November 5th,

We began setting up the medical equipment for the Pediatric Hospital of Pecs at 7:30 AM. Yesterday afternoon we toured the hospital to get an idea of what to expect for today. I was impressed with the hospital. It is operated very well and the doctors and nurses are knowledgeable and experienced. One of the hospital's larger problems is that they are understaffed in the neonatal intensive Care unit (NICU). In the USA there is typically a 3:1 ratio of nurse to infants, but if the infant is in very critical condition than the ratio is 2:1 or even 1:1.

Not here.

The ratio at the hospital is 6:1 in the NICU and there are some very severely ill infants. The nurses are constantly going back and forth between babies trying to keep up. The hospital also has a real need for additional medical equipment. Although they have some patient monitors, infant warmers and incubators, it's not nearly enough to handle all the infants in their care. Dr. Adamovich, who is in charge of the NICU, is anxious to get the equipment and installed so he can begin using it on patients. We expect to have patients on the monitors and in the incubators and warmers by tomorrow afternoon.

The team from Salinas Valley Memorial Hospital is doing a great job. The team is made of Sam Downing, CEO of SVMH, and his wife Paula; Brad Carrott, Director of Biomedical Engineering at SVMH; Annette Schuessler, director of ICU; Dr. David Kasting, neonatalogist, and his wife Anna, who is a nurse; Sue Marscellas, Marketing and Public Relations at SVMH; Mike Profuma, healthcare consultant, and his wife Judy. This morning we all jumped in to get the equipment ready. We had 14 patient monitors, 2 warmers, 1 incubator, 1 defibrillator, 4 bassinets, and all the accessories. The training begins tomorrow and we had to have most of the equipment set up for the first training session.

We did have a minor problem--the power cords were not right. They were European cords but they needed a right angle on the part that connected to the monitor. The hospital engineer and I jumped into his car and took off. It was like being in a rally car race. He would weave his way through backstreets and around cars. At a traffic light he would punch the accelerator hard to the floor and his little Peugot would dart down the street only to slam on the brakes at the next light. We ended up going to four stores but we finally found what we needed and then it was an all out race back to the finish line at the hospital. It was as good as any roller coaster ride.


God bless,
Ray Schmidt